Predictors of responses to corticosteroids for anorexia in advanced cancer patients: a multicenter prospective observational study

• Published in: Supportive care in cancer 2017, Vol.25 (1), p.41-50
• Main Authors: Matsuo, Naoki, Morita, Tatsuya, Matsuda, Yoshinobu, Okamoto, Kenichiro, Matsumoto, Yoshihisa, Kaneishi, Keisuke, Odagiri, Takuya, Sakurai, Hiroki, Katayama, Hideki, Mori, Ichiro, Yamada, Hirohide, Watanabe, Hiroaki, Yokoyama, Taro, Yamaguchi, Takashi, Nishi, Tomohiro, Shirado, Akemi, Hiramoto, Shuji, Watanabe, Toshio, Kohara, Hiroyuki, Shimoyama, Satofumi, Aruga, Etsuko, Baba, Mika, Sumita, Koki, Iwase, Satoru
• Format: Article
• Language: English
• Subjects: Adrenal Cortex Hormones - administration & dosage; Adrenal Cortex Hormones - pharmacology; Adrenal Cortex Hormones - therapeutic use; Adult; Aged; Aged, 80 and over; Anorexia; Anorexia - drug therapy; Cancer; Cancer metastasis; Cancer patients; Cancer research; Care and treatment; Cohort Studies; Corticosteroid drugs; Development and progression; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasms - complications; Nursing; Nursing Research; Oncology; Original Article; Pain Medicine; Palliative Care - methods; Rehabilitation Medicine; Steroids
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-016-3383-z

Purpose Although corticosteroids are widely used to relieve anorexia, information regarding the factors predicting responses to corticosteroids remains limited. The purpose of the study is to identify potential factors predicting responses to corticosteroids for anorexia in advanced cancer patients. Methods Inclusion criteria for this multicenter prospective observational study were patients who had metastatic or locally advanced cancer and had an anorexia intensity score of 4 or more on a 0–10 Numerical Rating Scale (NRS). Univariate and multivariate analyses were conducted to identify the factors predicting ≥2-point reduction in NRS on day 3. Results Among 180 patients who received corticosteroids, 99 (55 %; 95 % confidence interval [CI], 47–62 %) had a response with ≥2-point reduction. Factors that significantly predicted responses were Palliative Performance Scale (PPS) > 40 and absence of drowsiness. In addition, factors that tended to be associated with ≥2-point reduction in NRS included PS 0–3, absence of diabetes mellitus, absence of peripheral edema, presence of lung metastasis, absence of peritoneal metastasis, baseline anorexia NRS of >6, presence of pain, and presence of constipation. A multivariate analysis showed that the independent factors predicting responses were PPS of >40 (odds ratio = 2.7 [95 % CI = 1.4–5.2]), absence of drowsiness (2.6 [1.3–5.0]), and baseline NRS of >6 (2.4 [1.1–4.8]). Conclusions Treatment responses to corticosteroids for anorexia may be predicted by PPS, drowsiness, and baseline symptom intensity. Larger prospective studies are needed to confirm these results.